Patient Care Advocate

Centene Corporation

. Work with members and providers to close care gaps and remove barriers to care .

Posted 9/29/2026full-timeChristopher • Illinois • United StatesJuniorMid-Level💰 $27 - $49 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in HEDIS measures, ICD-10/CPT coding, and quality improvement interventions while effectively engaging with members and providers to enhance care experiences and compliance. Proficient in health coaching and community resource connection, with a strong focus on patient advocacy and collaboration.

Highest-signal resume keywords

HEDIS Measures KnowledgeICD-10/CPT Coding ExpertiseHealth Coaching ExperienceQuality Improvement SkillsBilingual in English and Spanish

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

HEDIS MeasuresICD-10 CodingCPT CodingQuality ImprovementHealth CoachingPatient CareData AssessmentCompliance StandardsCommunity Resource ConnectionProvider Education

Soft Skills

CommunicationCollaborationAdvocacyProblem-SolvingInterpersonal Skills

Certifications & Qualifications

Licensed Practical Nurse (LPN)Licensed Master Social Work (LMSW)Certified Social Worker (C-SW)Licensed Social Worker (LSW)Licensed Registered Nurse (RN)

Industry Keywords

Managed CarePatient AdvocacyPreventive ServicesHealth AdministrationPublic HealthSocial WorkHealthcare ComplianceTelephonic OutreachProvider RelationsMember Experience

About the role

Key responsibilities & impact

Work with members and providers to close care gaps and remove barriers to care
Improve member and provider experience through outreach and face-to-face interaction
Collaborate with providers in the field to improve HEDIS measures
Educate providers on HEDIS measures and coding
Support quality improvement interventions and provider audits
Assist in resolving deficiencies affecting compliance with State and Federal HEDIS standards
Conduct telephonic outreach and health coaching to members identified as needing preventive services
Provide face-to-face education to members and families about care gaps and barriers to care
Schedule doctor appointments and arrange transportation and follow-up appointments
Connect members with community-based resources and affinity programs
Act as liaison and member advocate between members/families, physicians, facilities, and agencies
Serve as WellCare's representative in provider offices
Advise provider practices on HEDIS ICD-10/CPT coding under NCQA requirements
Assess provider performance data and strategize provider improvement opportunities
Collaborate with Provider Relations on Quality, Risk Adjustment, Operations, claims, and encounters
Document all member-contact actions
Interact with departments including customer service to resolve member issues
Refer members to case or disease management as appropriate
Complete special assignments and projects
Perform other duties as assigned and comply with policies and standards

Requirements

What you’ll need

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Fluency in both English and Spanish is highly preferred
Must be able to travel to provider offices
Must be located in and around the service areas of Christopher, IL; East St. Louis, IL; Edwardsville, IL; Belleville, IL; Carbondale, IL; or Evansville, IN
Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related health field, or equivalent work experience required
A total of 4 years of experience required for the position when using the degree/equivalent experience requirement
At least 2 years of work experience in direct patient care, social work, quality improvement, or health coaching, preferably in a managed care environment
Preferred credentials include Licensed Practical Nurse (LPN), Licensed Master Social Work (LMSW), Certified Social Worker (C-SW), Licensed Social Worker (LSW), or Licensed Registered Nurse (RN)
Ability to maintain confidentiality of business and protected health information
Knowledge of HEDIS measures and HEDIS ICD-10/CPT coding in accordance with NCQA requirements
Ability to assess provider performance data and identify improvement opportunities

Benefits

Comp & perks

Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation
Equal opportunity employer committed to diversity